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Nikki Isis Matus, NURSEPRACTITIONER
Primary Care Nurse Practitioner in Stony Brook, New York
NPI 1063142529

Nikki Isis Matus is a Primary Care Nurse Practitioner based in East Setauket, NY and is specialized in Primary Care. Nikki Isis Matus practices in Stony Brook, NY and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Nikki Isis Matus is 1063142529 and holds a License No. 310367 (New York).

The current practice location address for Nikki Isis Matus is 101 Nicolls Rd, Stony Brook, NY and can be reached out via phone at 631-807-4241.

Location: 101 Nicolls Rd, Stony Brook, NY, 11733-2000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063142529
Provider Name
Nikki Isis Matus
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
101 Nicolls Rd, Stony Brook, NY, 11733-2000
Phone Number
631-807-4241
Fax Number
Provider Enumeration Date
06/16/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-0001
Phone Number
631-807-4241
Fax Number
person
Provider Business Mailing Address Details
Address
101 Nicolls Rd
City
Stony Brook
State
New York
Zip
11794-0001
Phone Number
631-807-4241
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
310367 (New York)
Definition
Definition to come...
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